A brief history

Rwanda is making great efforts to achieve universal health coverage by 2030, in line with Sustainable Development Goal 3 on good health and well-being for all. Its efforts to strengthen its health care systems have been a work in progress since the Rwandan genocide, also known as the genocide against the Tutsi, in 1994. During the atrocities, buildings such as health care facilities were destroyed or damaged, and huge numbers of health care workers died or fled elsewhere, leaving capacity at an extreme low. Following the genocide, HIV also had a prevalence rate between 25% and 33%, there was a cholera epidemic in the refugee camps, and Rwanda had the highest child mortality rate in the world.

In order to rebuild society, the new government included integrating health as a human right into Rwanda’s constitution in 2013, began training community health workers, and launched a compulsory community-based insurance scheme, which covers just over 81% of the population, according to the Rwanda Social Security Board in 2016. While the system means all Rwandans must make financial contributions to the scheme based on income and vulnerability and then pay 10% of any services they receive, care is now more affordable, Mbanjumucyo said.

Although the validity of government data has been questioned, according to WHO Rwanda has one of the highest life expectancies in sub-Saharan Africa averaging 68 years, higher than the 57 years elsewhere, and the under-5 mortality rate has dropped to 38 deaths per 1,000, compared to 225 in 1998.

“E-health is something growing, definitely,” Mbanjumucyo said, adding that with good internet coverage now in parts of the country, more e-health solutions are being implemented to reach more people.

In the heart of Kigali, with the help of the internet, one digital health solution could be a diagnostic lifeline if rolled out in more remote and rural areas as planned.